Understanding Fontan circulatory failure using exercise CMR
Research type
Research Study
Full title
Understanding the mechanism of failing Fontan circulation using bicycle ergometry stress cardiac MRI
IRAS ID
226670
Contact name
Phuoc Duong
Contact email
Duration of Study in the UK
1 years, 11 months, 31 days
Research summary
In the UK and worldwide, adult patients with failing Fontan circulation is increasing and yet there is very little understand upon the exact physiological mechanism of this disease process. Many of these patients are asymptomatic despite evidence of multi organ or circulatory failure when they have the test carried out. In fact these population of patients are not receiving enough investigation as many believe that little could be changed about the outcome. The only currently available treatment option for these patients is heart transplantation, which carries high mortality risk.
We are suggesting the use of cycling with real-time cardiac MR imaging during haemodynamic study as it is closest to the physiological condition of the patient and therefore the finding would closely reflect the pathophysiological difference in these patients. With better knowledge, we would be able to offer additional surgical intervention at earlier stage, or giving appropriate anaesthetic strategy and intensive supportive treatment (mechanical circulatory support, correct types of drug treatment), or listing these patients early for heart transplantation.
The purpose of this study is to provide fundamental knowledge into the exact mechanism of failure so that treatment therapy could be tailored towards.
The novelty of this research project is to suggest the use of bicycle ergometry (exercise tolerance test) as the form of stressing the circulation during the cardiac MRI study, which is different from the current standard of infusing drugs to achieve similar effects during the cardiac MRI study.
REC name
London - Westminster Research Ethics Committee
REC reference
17/LO/1659
Date of REC Opinion
29 Dec 2017
REC opinion
Further Information Favourable Opinion